Publication: Adverse drug reactions of acetylcholinesterase inhibitors in older people living with dementia: A comprehensive literature review
Issued Date
2021-01-01
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ISSN
1178203X
11766336
11766336
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2-s2.0-85116085577
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Mahidol University
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SCOPUS
Bibliographic Citation
Therapeutics and Clinical Risk Management. Vol.17, (2021), 927-949
Suggested Citation
Sirasa Ruangritchankul, Prawat Chantharit, Sahaphume Srisuma, Leonard C. Gray Adverse drug reactions of acetylcholinesterase inhibitors in older people living with dementia: A comprehensive literature review. Therapeutics and Clinical Risk Management. Vol.17, (2021), 927-949. doi:10.2147/TCRM.S323387 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/76556
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Title
Adverse drug reactions of acetylcholinesterase inhibitors in older people living with dementia: A comprehensive literature review
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Abstract
The rising of global geriatric population has contributed to increased prevalence of dementia. Dementia is a neurodegenerative disease, which is characterized by progressive deterioration of cognitive functions, such as judgment, language, memory, attention and visuospatial ability. Dementia not only has profoundly devastating physical and psychological health outcomes, but it also poses a considerable healthcare expenditure and burdens. Acetylcholinesterase inhibitors (AChEIs), or so-called anti-dementia medications, have been developed to delay the progression of neurocognitive disorders and to decrease healthcare needs. AChEIs have been widely prescribed in clinical practice for the treatment of Alzheimer’s disease, which account for 70% of dementia. The rising use of AChEIs results in increased adverse drug reactions (ADRs) such as cardiovascular and gastrointestinal adverse effects, resulting from overstimulation of peripheral cholinergic activity and muscarinic receptor activation. Changes in pharmacokinetics (PK), pharmacodynamics (PD) and pharmacogenetics (PGx), and occurrence of drug interactions are said to be major risk factors of ADRs of AChEIs in this population. To date, comprehensive reviews in ADRs of AChEIs have so far been scarcely studied. Therefore, we aimed to recapitulate and update the diverse aspects of AChEIs, including the mechanisms of action, characteristics and risk factors of ADRs, and preventive strategies of their ADRs. The collation of this knowledge is essential to facilitate efforts to reduce ADRs of AChEIs.